20000074.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ALLOWED
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AREA
1PROPOSED
HEIGHT
ALLOWED
1PROPOSED
LOT COVERAGE
ALLOWED I PROPOSED
REQUI RED SETBACKS (FT.)
FRONT SIDE REAR
PROPOS ETBACKS (FT)
ED
FRONT URSIDE FEAR
LOT AREA
DATE
REMARKS
CHECKED By b;;jUCTION
OCCUPANT
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SPECIAL INSPECTOR
REWIRED 13 YES
AREA
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LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 108
FINAL INSPECTION REQUIRED
PUN CHECK FEE
BUILDING
AT s-U--E
HEAT SOURCE:
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PLUMBING
P I'n Check No.
Plan Check No..
MECHANICAL
This Permit covers work to be done on private property VNLT.
This Permit Cover. Work
GRADINGIFILL
Any construction on the public domain (curbs, sidewPIks,
An, . IT air.., 'on on I
driveways, marquees, etC.) will require Separat a permission.
STATE SURCHARGE
Permit Application: 180 Days
OTOR. DRAINAGE FEE
Permit Limit: I Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of hi s or her spouse, heirs, assigns and
END, INSPECTION FEE
Su cessors in interest, agrees to indemnity, defend and hold
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harmless the City of Edmonds, Washington ' its "Ificial'i
employees, and agents from any and all claims for damages
.
whatever nature. arising directly or indirect 1, y from the i:suance
IsSuSC his sha�l not be de Tried
to
PLAN VHECK DEPOSIT
11 this permit. of permit
ad..: any r.,Ur..en, 0
mod! a an city ordinance
ly w We Or f y
nor I I- I in any way the City's ability to enforce any ordinan
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-a
TOTAL AMOUNT DUE
WV3 11111
Provision."
I In.. read this application; that the
pplic
I h a y ac now::d-g-or"�hc'!
ATTENTION
APPLICATION APPROVAL
and I
inl.re' B 'Iblon 9"V-n that am the own.,, or 11he dul
m
the owner. I gre om Y irh City and
Y
THIS PERMIT
is until
authorized agent of
a,., , laws regulating cOR6lruCIJpnTdi1,ntCc%1 1ph'- w k aUthorz-
AUTHORIZES
This application not a permit
signed by the Building official or his/her
.d thereby no Person will employed in Violation of the Labor
ONLY , E
WORK NOTED
Deputy: and fees are Paid. anddreneipt is
Code of tlh� State of Washington rel at Ing to Workmen's ComPensa-
acknowledged in space provide
tion Insurance ano RQ14 18.27.
INSPECTION
DEPARTMENT
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CITY OF
OFFICNiqSS1n UR , I AT
1:
40S
EDMONDS
CALLIFOR
AELEASED 9.
AT�NTION
INSPECTION
OR sT
IT S UNLAWFUL TO USE OR OCCUPY A BUILDINI 'uT"E
A FINAL INSPECTION HAS 13EIN MADE AND APPROVAL-
771-0220
OR, GINAL — FOS YELLOW — inspector
111,1711.
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...................
FOUNDATION:
Footing., . .................
Wall.......................
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Pier/Porch ..........
RetainingWall ............
ShIbInsulflon .....
PLUMBING:
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Underground .............
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Rough -in .................
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Commercial Final:
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HEATING:
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GasTest....
GasPiping ................
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Equipment ... ........
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EXTERIOR SHEATHING
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NAILING ....................
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FRAMING ...... .............
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INSULATION;
FI oor Insulation.:.
Well Insulation ....
Calling Insulation .........
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SHEETROCK NAILING ......
SPECIAL INSPECTION ......
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MISCELLANEOUS
FINAL APPROVAL
FDOOOSOPMRUY ..........
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USE PERM11
CITY OF EDMONDS ZONE NUMBER zatoW 4,
CONSTRUCTION PERMIT APPLICATION G,
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STATE LICENSE NUMBER
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YES . No.
REMARKS
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ENGINEERING MEMO DATED
REVIINVED BY
EvIEWED.Y
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SERA REVIEW ---iIGN A—REA HEIGHT
COMPLETE I EXEMPT ALL ED 11ROPOIED ALLOWED 1PROPOSED
XP
LOT COVERAGE REQUIRED SETBACKS IFT-) PROPOSED SETBACKS
ALLOWED j PROPOSED FRONT SIDE REAR FRONT A SIDE REAR C
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P.—I N. �OoDi
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NEW ZAESIDENTIAL PLUMBIN ECH
REMARKS
CO PLIANCE OR
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AOUITI El C.M E CHANGE OF USE
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ON COMMERCIAL
LAPT.BLDG,
G SIGN
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REMODEL
0 GRADING FENCE
Ns 010� OCCUPANT
GROUPf
REPAIR
Fn
DEMOLISH [] 'INSERTT'Ve SWIM POOL
HOT TUB/SPA
SPECIAL INSPECTOR
GARAGE [j RETAINING WALL/
RENEWAL
AEOUIRED 13 YES
MARKS
CARPORT ROCKERY
PROGRESS INSPECTIONS PER UBC 108
YPE OF USE. BUSINESS OR ACTIVITY) EXPI-AIN
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'NUMBER
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NUMBER OF CRITICAL
P EAS
DWELLING,
UNI S NUMBER
DESCRIBE WORK TO BE DONEATTACH
P�j
:OT
FINAL INSPECTION REQUIRED
:7-5/1 -IETu
VALUA ION
FEE
PLAIN CHECK FEE
BUILDING
HEAT SOURCE: GLAZING
PLUMBING
Plan Check No.
MECHANICAL
A-) ct,
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
(curlEs,
Any construction on the pub sidewalks,
r=ln
p
driveways, marquees. etc.) wiliic separate er.isslon.
STATESURCHARGE
P 'P 'on 0
STORM DRAINAGE FEE
Work it Started Within 180 Days
Applicant. on behelf of his or her spouse, heirs, assigns
and ENO. INSPECTION FEE
successors in inieyrest r.. to indemnity. defend arid hold
'
'Ecim.rd.,
I f
Washington, is olicials.
0 a 0"
harmless the C j
ifor'di.rinalc.i.
asi
2 employees, and om any arid all claims
agents "'
0
,m whatever nature, Brain, directly or Indirectly from the Issuance
Issuance of this permit shalt not be deemed
to PLAN HECK DEPOSIT
I this permit.
modify, walve or reduce any,requimm.rit of any city ordinance
nor limit In any way the Ity a ability to enforce any ordinance
C
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that th I APPLICATION APPROVAL
ATTENTION
information *given is correct; and that I am the owner, or the duly
auth D'ized agent Of the owner. I agree to comply with city and THIS This application is not a permit until
OPERMIST
RIZE
5ta a laws regulating construction; and In doing the work authorIz- AUTH� TIE signed by the Building Official or his/her
I
the Labor N
d thereby, no person will be employed in violation 0 d fees am paid. and receipt is
WORK NOTED Deputy;
lah
Code of the State of Washington relating to Workmen's Compensa- acknow edged in space provided.
INSPECTION
FICW 18 27 OEPAATIVENI
OWNER OF FFICI S SIG TURE
CITY OF
EDMONDS
CALI. FOR RELEASED By
TION INSPECTION
PY A BUILDING OR STRUCTURE
APPROVAL ORIGINAL. FOS YELLOW — inspector
IT S UNLAWFUL TO USE OR OCCU OR 771-0220
UN711. A FINAL INSPECTION HAS BEEN MADE AND
HAS BEEN GRANTED. UBC
A CERTIFICATE OF OCCU FANCY PINK — 0--er GOLD A,SESS.1
SECTION 109
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